Maternal Epidural Pain Relief and its Impact on Fetal Doppler Study During Labor and Immediate Neonatal Outcome
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- Category: Vol. 82, December 2014
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Maternal Epidural Pain Relief and its Impact on Fetal Doppler Study During Labor and Immediate Neonatal Outcome, IBRAHIM ABO EL-MAGD, AHMED T. ABD EL-FATTAH, AHMED A. ABDALLAH and SAID S. YOUSEF
Abstract
Background: Laboring women often experience intense pain. Uterine contractions result in visceral pain, while in descent, the fetus’ head exerts pressure on the mother’s pelvic floor, vagina, and perineum, causing somatic pain. Epidural analgesia (EA) is the most effective treatment for pain control during labor and delivery. The aim of this study to evaluate the impact of epidural analgesia on fetal Doppler during labor and neonatal outcome.
Methods: This prospective study included 90 pregnant ladies in labor attending the labor room divided into 2 groups, 1st group patient in active labor stage with epidural analgesia (case group), 2nd group patient in active labor stage without epidural analgesia (control group). The following will be monitored, Cardiotocography (CTG), Doppler studies, Parto-gram, Maternal vital signs (pulse, blood pressure), length of first stage and second stage of labor, mode of delivery, neonatal birth weight, Apgar score at 5min, Umbilical arterial PH.
Results: The effect of epidural analgesia on the Umbilical artery Resistance index (RI) and Pulsatality index (PI) and middle cerebral artery (MCA) RI and PI was recorded in patients before and after epidural there were no significant difference between any of the parameters tested. There is no differences on the duration of labor, reactivity of CTG, meconium staining liquor, mode of delivery, Apgar score, NICU admission and on Umbilical artery PH. There is brady-cardia after epidural analgesia but not significant. There is significant hypotension after 5 minutes.
Conclusion: Epidural analgesia seems to be safe regarding fetal Doppler, progress of labor and fetal outcome.